The Framingham Heart Study (FHS)  which helped give the world the term "risk factor" to describe behaviors or conditions that increase the chance of disease  is about to enter a new phase by recruiting its third generation of participants. FHS scientists expect the Third Generation Study to yield even more breakthroughs about factors that promote the development of cardiovascular and other diseases.

Begun in 1948, FHS is part of the National Heart, Lung, and Blood Institute (NHLBI). The new phase was announced by NHLBI and Boston University, which has been associated with the study since 1971. Boston University faculty have worked closely with FHS scientists, including providing guidance on research directions.

FHS plans to recruit about 3,500 grandchildren of the study's original enrollees. Recruitment of the original group of 5,209 men and women began in 1948. In 1971, the Framingham Offspring Study was created, adding 5,124 more men and women-children of the original participants-along with their spouses.

"The expansion to a third generation opens up the chance to explore important new questions about disease risk, especially those related to genetics," said NHLBI Director Dr. Claude Lenfant.

"We've come a long way in our understanding of what influences the disease process since the study began," continued Lenfant. "That knowledge has contributed to dramatic declines in deaths from heart disease and stroke over the past 30 years. The death rate from heart disease has declined by more than 50 percent and that from stroke by more than 60 percent.

"But these are complicated diseases and many questions remain unanswered," he added. "With the help of another generation of participants, FHS may close in on the root causes of cardiovascular disease and, so, develop new and better ways to prevent, diagnose, and treat cardiovascular disease."

"Boston University has been honored to participate in this landmark epidemiological study," said Dr. Aram Chobanian, Provost, Boston University Medical Campus, and Dean, Boston University School of Medicine. "Our researchers have helped change people's basic habits and, in doing so, have improved the health and well-being of countless lives. Boston University School of Medicine looks forward to its leadership role in advancing research and making more discoveries in the next phase of this important study."

"Researchers at Boston University have led the way in FHS studies of various manifestations of aging, including stroke, dementia, osteoarthritis, osteoporosis, and visual and hearing loss," said Dr. Philip A. Wolf, Professor of Neurology at Boston University School of Medicine and Principal Investigator of the FHS contract. He added that the Third Generation Study's participants will make vital contributions to scientists' understanding of the role of genetics in the development and progression of these aging-related diseases.

Framingham, MA, is about 20 miles inland from Boston. According to FHS Director Dr. Daniel Levy, it was chosen as the site for the FHS-the first, long-term, population-wide epidemiological study-in part because of its proximity to major medical centers and its participation in an earlier Government study on tuberculosis.

Participants undergo periodic medical examinations, including a physical, an electrocardiogram, and such laboratory tests as blood pressure and blood cholesterol measurements.

Scientific analyses of the data from those examinations have led to such medical breakthroughs as showing that cigarette smoking, high cholesterol, high blood pressure, obesity, and diabetes increase the risk of heart disease.

"Back when the study began, the notion of 'risk factors' for disease was unheard of," said Levy. "But their identification led to a new approach to disease-one that enables people to take action to reduce their chance of getting heart disease.

"When the Framingham Offspring Study began," Levy continued, "it allowed us to begin to explore family patterns in the occurrence of cardiovascular disease, including the effects of genetics on high blood pressure, high cholesterol, obesity, diabetes, and asthma. The new Third Generation Study is vital to that investigation."

Key goals of the Third Generation Study are to:

Identify new risk factors for cardiovascular, lung, and blood diseases

Identify genes that contribute to good health and to the development of cardiovascular, lung, and blood diseases

Develop new imaging tests that can detect very early stages of coronary atherosclerosis in otherwise healthy adults

"The collaboration between FHS scientists and participants has been remarkable," said Levy. "The study has been possible only because of the participants' dedication. All of our discoveries are their gift to the world."

To interview an FHS scientist, contact the NHLBI Communications Office at (301) 496-4236. To interview Chobanian, contact the Boston University Corporate Communications Office at (617) 638-8491.